Along with other leading medical organizations, The American Cancer Society recommends informed decision-making when it comes to screening for prostate cancer. What this means is that every man should make his own decision, along with his medical care providers, about whether to be screened.

Screening or testing to find a disease in people without symptoms can help find some types of cancer early, when it’s more easily treated. But for some men, the risks of prostate cancer screening may outweigh the benefits. Asking questions is an important step in deciding whether to be screened.

Q: What are the screening tests for prostate cancer?

A: There are 2 main screening tests for prostate cancer

The PSA test is a blood test to check the level of prostate-specific antigen in your blood. Most healthy men have levels under 4 nanograms per milliliter of blood. But everybody is different, and a lower PSA level doesn’t guarantee a man is free of cancer, just like a higher level doesn’t mean he has cancer.

For the digital rectal exam (DRE), a doctor inserts a gloved, lubricated finger into the rectum to feel for any bumps or hard areas on the prostate that may need to be tested for cancer. This test may be done with the PSA or the PSA may be done alone.

Q: What if the results are not normal?

A: If the results of the PSA and/or DRE suggest that you might have prostate cancer, your doctor will do a prostate biopsy to find out. A sample of prostate tissue is removed using a needle and sent to a lab, where a specialist will look at it to see if it contains cancer cells.

Q: At what age should I have my first screening test?

A: The American Cancer Society recommends men learn as much as they can about prostate cancer screening risks and benefits and discuss the information with their doctor before deciding whether to be tested at all. Men at average risk of prostate cancer should have this discussion starting at age 50. Men at higher than average risk should have the discussion starting at age 40 or 45.

Q: Who is at higher than average risk for prostate cancer?

A: African American men and men who have a father, brother, or son who were diagnosed with prostate cancer when they were younger than 65 are at high risk. Men with more than one of these close relatives diagnosed before age 65 are at even higher risk.

Q: Why shouldn’t all men be screened for prostate cancer?

A: It seems like it makes sense to check everyone to find out if they have cancer. But screening isn’t perfect. Sometimes screening misses cancer, and sometimes it finds something suspicious that turns out to be harmless. Also, there aren’t reliable tests yet to tell the difference between prostate cancer that’s going to grow so slowly it will never cause a man any problems, and dangerous cancer that will grow quickly. In addition, studies have not been able to show that annual PSA screening helps men live longer. However, most men who find out they have cancer want to treat it. Treatments for prostate cancer can have urinary, bowel, and sexual side effects that may seriously affect a man’s quality of life. So, testing really is a decision that men should make after they have all the information.